Physical & Chemical Injuries

Question 1

Common alteration on the buccal mucosa; most likely with pressure or frictional irritation:

Answer 1

Linea alba

Question 2

Clinical features:

-B/L white line at level of occlusal plane
-may appear scalloped
-common

Answer 2

Linea alba

Question 3

What is the treatment for lines alba?

Answer 3

Treatment not indicated

Question 4

Morsicatio buccarum, morsicato labiorum:

Answer 4

Chronic mucosal chewing

Question 5

Chronic mucosal chewing is often observed in:

Answer 5

stress/psychological situations

Question 6

Clinical features:

-thickened, shredded white areas
-MC on buccal mucosa
-May have areas of erythema or ulceration

Answer 6

Chronic mucosal chewing

Question 7

What is the treatment for chronic mucosal chewing?

Answer 7

Treatment not indicated

Question 8

Often caused by acute or chronic injuries such as a sharp cusp on a tooth:

Answer 8

Traumatic ulceration

Question 9

_____ ulcers are caused medication intervention (trauma from dental instrument or anesthesia)

Answer 9

Iatrogenic

Question 10

Iatrogenic ulcers are an example of:

Answer 10

Traumatic ulceration

Question 11

What form of traumatic ulceration is considered histologically unique?

Answer 11

Traumatic ulceration with stromal eosinophilia (TUGSE)

Question 12

Clinical features:

-MC on tongue, lips, buccal mucosa
-area of erythema and fibrinous exudate
-often appears crater-like
-may have hyperkeratotic collar

Answer 12

Traumatic ulceration

Question 13

Differential diagnoses for traumatic ulcerations: (3)

Answer 13

1. deep fungal infection
2. syphilitic ulcer
3. squamous cell carcinoma

Question 14

Treatment for traumatic ulceration:

Answer 14

1. remove source of irritation if present
2. biopsy for longstanding lesions

Question 15

Accounts for 5% of all burn admissions:

Answer 15

oral cavity electric burns

Question 16

Clinical features:

-MC site in adults: hands
-MC site in children: oral cavity- lips most frequent
-Charred area, that becomes necrotic

Answer 16

Electrical burns

Question 17

Most common area for electrical burns in adults:

Answer 17

Hands

Question 18

Most common area for electrical burns in children:

Answer 18

mouth

Question 19

Often occur from hot foods/beverages:

Answer 19

thermal burns

Question 20

Clinical features:

-most common on palate or posterior buccal mucosa
-zones of erythema & ulceration
-necrotic epithelium

Answer 20

Thermal burns

Question 21

Answer 21

Linea alba

Question 22

Answer 22

Chronic mucosal chewing

Question 23

Answer 23

Chronic mucosal chewing

Question 24

Answer 24

Traumatic ulceration

Question 25

Answer 25

Electrical burns (child)

Question 26

Answer 26

Thermal burn

Question 27

Treatment for thermal & electrical burns include:

Answer 27

1. prophylactic antibiotic for severe cases 2. appliances to prevent microstomia 3. surgical intervention

Question 28

Chemicals & drugs placed in the oral cavity that cause caustic injuries:

Answer 28

Chemical injuries

Question 29

Dental related chemical injuries can be due to: (4)

Answer 29

1. silver nitrate 2. formocresol 3. sodium hypolchlorite 4. acid etch materials

Question 30

What common drug can induce chemical burn?

Answer 30

aspirin

Question 31

Aspirin may cause:

Answer 31

mucosal necrosis

Question 32

Clinical features: -white areas of epithelial necrosis -may slough off (tissue) -mucosal necrosis

Answer 32

Chemical burn- aspirin

Question 33

Treatment for an aspirin chemical burn:

Answer 33

1. prevent exposure 2. limit use

Question 34

What type of sexual activity may cause trauma to the oral mucosa?

Answer 34

Orogenital

Question 35

Clinical features: -palatal petechiae -fibrous hyperplasia

Answer 35

Oral trauma from sexual acts

Question 36

Differential diagnosis for oral trauma caused by sexual acts:

Answer 36

1. trauma 2. violet coughing 3. platelet abnormalities 4. viral infections

Question 37

Treatment for oral trauma caused by sexual acts:

Answer 37

No treatment indicated

Question 38

Implantation of dental amalgam into oral mucosa:

Answer 38

amalgam tattoo

Question 39

Amalgam tattoo may be incorporatied into the oral mucosa in many ways including: (4)

Answer 39

1. after restorative material 2. fractured amalgam restorations 3. contaminated dental floss 4. endodontic treatment

Question 40

Differential diagnosis for amalgam tattoo: (4)

Answer 40

1. melanotic macule 2. melanoma 3. tattoos 4. graphite (pencil)

Question 41

Treatment for amalgam tattoo:

Answer 41

None if diagnosis confirmed - biopsy if not

Question 42

Anticancer therapy may result in damage to:

Answer 42

normal tissue

Question 43

A common site for cancer complications:

Answer 43

oral cavity

Question 44

Oral complications of cancer therapy is related to:

Answer 44

Radiation & chemotherapy

Question 45

Clinical features: -Mucositis -Hemorrhage -Xerostomia

Answer 45

Oral complications of cancer therapy

Question 46

Occurs in 80% of patient treated with head & neck radiation:

Answer 46

Mucositis

Question 47

Mucositis may present as:

Answer 47

1. atrophic mucosa 2. edema 3. erythema

Question 48

Describe the atrophic mucosa seen mucositis:

Answer 48

ulcerations & epithelial necrosis

Question 49

Usually secondary to thrombocytopenia; develops from bone marrow suppression:

Answer 49

hemorrhage

Question 50

Salivary glands are sensitive to radiation therapy; this can also cause caries

Answer 50

Xerostomia

Question 51

Treatment for oral complications of cancer therapy (Mucositis) include:

Answer 51

Topical anesthetics, pain medication, coating agents

Question 52

Treatment for oral complications of cancer therapy (Xerostomia) include:

Answer 52

Sugarless candy, medications, fluoride trays

Question 53

Answer 53

chemical injury

Question 54

Answer 54

chemical injury

Question 55

Answer 55

chemical burn - aspirin

Question 56

Answer 56

Oral trauma from sexual activity

Question 57

Answer 57

oral trauma from sexual activity

Question 58

Answer 58

amalgam tattoo

Question 59

Answer 59

amalgam tattoo

Question 60

Answer 60

Oral complication of cancer treatment

Question 61

Answer 61

Oral complication of cancer treatment

Question 62

Abnormal growth of gingival tissues secondary to use of systemic medication:

Answer 62

drug-related gingival hyperplasia

Question 63

Drug-related gingival hyperplasia is strongly associated with what drugs:

Answer 63

1. phenytoin 2. nifedipine 3. cyclosporine

Question 64

Clinical features: -gingival enlargement originating in interdental papillae -spreads across tooth surface -edentulous areas usually not affected

Answer 64

Drug-related gingival hyperplasia

Question 65

Treatment of drug-related gingival hyperplasia:

Answer 65

1. Discontinuation of offending medication 2. oral hygeine 3. surgery

Question 66

T/F: Drug-induced gingival hyperplasia greatly affects edentulous areas

Answer 66

False- usually does not affect edentulous areas

Question 67

Denture Epulis may also be called:

Answer 67

1. Epulis fissuratum 2. inflammatory fibrous hyperplasia

Question 68

Hyperplasia of fibrous connective tissue due to ill-fitting denture/partial:

Answer 68

Denture epulis

Question 69

Clinical features: -Folds of hyperplastic tissue in alveolar vestibule -firm & fibrous -kay be erythematous

Answer 69

Denture epulis

Question 70

Treatment for denture epulis:

Answer 70

1. surgical removal 2. denture should be remade or relined

Question 71

Often arises from traumatic event resulting in hemorrhage within tissues:

Answer 71

Submucosal hemorrhage

Question 72

Non-traumatic causes of submucosal hemorrhage:

Answer 72

1. anticoagulant therapy 2. thrombocytopenia 3. viral infections 4. hemorrhagic disease

Question 73

Clinical features: -Petechiae -Purpura -Ecchymosis -Hematoma

Answer 73

Submucosal hemorrhage

Question 74

Minute hemorrhage on skin or mucosa (tiny):

Answer 74

Petechiae

Question 75

Slightly larger area of hemorrhage (4-10mm):

Answer 75

Purpura

Question 76

Hemorrhage greater than 1cm:

Answer 76

Ecchymosis

Question 77

Hemorrhage that produces a large mass:

Answer 77

Hematoma

Question 78

Treatment for submucosal hemorrhage:

Answer 78

1. may resolve spontaneously 2. directed at treated the underlying cause

Question 79

Several medications may be implicated such minocycline, AIDS meds, Estrogen, Ketoconazole:

Answer 79

Drug-related discolorations

Question 80

Clinical features: -Diffuse melanosis of mucosal surfaces -MC in females

Answer 80

Drug-related discolorations

Question 81

Treatment of drug-related discolorations:

Answer 81

Discontinuing medication usually results in regression over time

Question 82

What are some medications that may cause drug-related discolorations: (4)

Answer 82

1. minocycline 2. AIDS meds 3. estrogen 4. ketoconazole

Question 83

Topical antibiotic in petrolem base produces a foreign-body reaction:

Answer 83

Myospherulosis

Question 84

Myospherulosis may occur at:

Answer 84

Surgical extraction site

Question 85

Clinical features: -Extraction surgical site (mandibular molars) -Occasional facial swelling -Radiograph (circumscribed radiolucency)

Answer 85

Myospherulosis

Question 86

Treatment for myospherulosis:

Answer 86

surgical removal

Question 87

Answer 87

Drug-related gingival hyperplasia

Question 88

Answer 88

Drug-related gingival hyperplasia

Question 89

Answer 89

Denture epulis

Question 90

Answer 90

Submucosal hemorrhage

Question 91

Answer 91

Submucosal hemorrhage

Question 92

Answer 92

Drug-related discoloration

Question 93

Answer 93

Drug-related discoloration

Question 94

Answer 94

Myospherulosis

Question 95

Answer 95

Myospherulosis